Welcome to Dementech

  • English

Opening Hours : Monday to Sunday - 8am to 8pm
  Contact : +44 20 3848 4500

Movement Disorders

Movement disorders are neurological conditions that affect the speed, fluency, quality and ease of movements. Mood changes and memory problems can also coexist. In addition, abnormal posture or movement may result in severe pain. Movement disorders may be severely debilitating and may affect peoples ability to function well and live independently. There are various types of movement disorders and they are often caused by changes in the brain. At Dementech we takes a multidisciplinary approach, with a focus on providing state-of-the art care for patients with Movement disorders, enabling them to participate in their treatment and facilitate improvement of their symptoms.

Parkinson’s disease (PD) is a chronic and progressive neurological condition characterised by slowness of movement, stiffness, shaking and impaired balance. Along with these symptoms, people might experience speech problems (softened voice, slurred speech), swallowing problems, bowel and bladder problems, difficulties at night (discomfort in bed, cramps, disturbed sleep pattern) and tiredness during the day. Skin can become greasy and people might experience excessive sweating. Constipation, bladder and sexual problems are common. People often experience depression, anxiety and memory problems. The progression of PD varies among different individuals. Symptoms continue and worsen over a period of years. Only about 10-15% of PD cases have been linked to a genetic cause, whereas most cases of PD are called idiopathic or sporadic, meaning the cause is unknown.

PD involves the malfunction and death of vital nerve cells in the brain. Some of these dying nerve cells produce a chemical, which sends messages to the part of the brain that controls movement. The exact causes behind the progressive loss of nerve cells are still unknown.

There are many medications and advanced treatments (including surgery) available to treat the symptoms of PD, although none yet that actually reverse the effects of the disease. Moreover, the effectiveness of the main drug treatment L-DOPA can wear off over time and its long-term use can cause some people to develop involuntary twisting movements of the arms, legs or face called dyskinesia.

At Dementech Neurosciences, we offer a multidisciplinary approach to treat all the variety of symptoms of PD. We have in-house speech and language therapist, occupational therapist, dietitian, psychologist and psychiatrist to manage effectively PD symptoms and complications. We use state-of-the-art technology such as the PKG to monitor and effectively treat symptoms and complications of PD. Cognitive dysfunction is often an early feature of PD occurring even at the early stage of the disease. At Dementech Neurosciences we use cutting-edge technology CANTAB to assess the severity of cognitive deficits in people with PD. This enables us to provide an early diagnosis of cognitive impairment and effectively manage it. We also provide genetic screening and counselling for the known genes associated to the familial forms of PD. Moreover, we offer the opportunity to participate in clinical trials testing novel pharmacological intervention, before they become available to the public, aiming to delay the progression of the disease.

Genetic Counselling

About 10-15% of all cases of PD are thought to be genetic forms of the disease. To date, abnormalities in particular genes have been linked to an elevated risk of PD. Several genes have been linked to PD. The three most common genes related to Parkinson’s are PARK2 (parkin), LRRK2 (leucine-rich repeat kinase 2) and Glucocerebrosidase (GBA). Mutations in the GBA gene are most common in the general population. Mutations in the LLRK2 gene are most common in certain ethnic groups, accounting for about 30-40% of PD cases in North African Arabs and about 15% of PD cases in people of Ashkenazi Jewish descent. A gene called SNCA (which encodes alpha-synuclein) is common in several families with a high prevalence of PD. Alterations in certain genes, including GBA, do not cause PD but appear to modify the risk of developing the condition in some families. Several other genes are known to cause PD.

At Dementech Neurosciences we offer genetic testing for the most and less common mutations associated with PD.

Diagnosis – Prevention – Risk Assessment – Management

At Dementech Neurosciences Clinic we are offering end-to-end services for all the different levels of care that a patient requires.

Risk assessments, prevention strategies and tools are used, as it is far more efficient to prevent a disease from developing rather than try to treat it once it has progressed.

However, in cases where a diagnosis of a disease has been established, our multidisciplinary team will do everything humanly possible to treat symptoms and prevent them from progressing further, hence improving the quality of each, the emotional health and the well-being of each individual.

Initial Assessment and Diagnostic testing

The initial appointment for Parkinson’s Disease will consist of the following:

  1. Initial consultation with a specialist physician.
  2. Appointment with a neuropsychologist in the Neuropsychiatric Laboratory for computerized, detailed assessments of cognitive deficits and other neuropsychiatric issues associated with movement disorders.
  3. Appointment for the PKG Service, which is a wrist worn device, that looks like a watch and automatically records movement data to assist in their diagnosis and treatment of the symptoms of movement disorders.
  4. Blood tests and imaging scans, outsourced to the highest quality and convenient centres in London.
  5. When all results are available, a 2nd consultation with the doctor, where clinical diagnosis & follow-up strategy are discussed and explained.

Essential Tremor (ET) is considered the most common neurologic movement disorder. ET is a chronic condition characterized by involuntary, rhythmic shaking of a body part, most typically the hands and arms. Handwriting becomes less legible and drinking liquids is also difficult to manage and it may be necessary to use either hands or a straw. Tremor can affect also the head with the shakiness being a ‘yes-yes” or a “no-no” movement. This can lead to embarrassment and possibly social withdrawal. Shakiness of the voice may also occur giving a quavering intonation when speaking. Tremor can also affect the trunk and legs. ET can affect people of any age and usually becomes worse when a person is stressed, tired, angry, anxious, hot or cold. Little is known about what causes this tremor. There are currently several medications that can decrease the severity of tremor but there is no medication that will permanently remove essential tremor from a person who is affected by it.

At Dementech Neurosciences, our doctors will provide a comprehensive assessment of the type and severity of tremor and offer pharmacological intervention including injections for the treatment of this invalidating condition.

Diagnosis – Prevention – Risk Assessment – Management

At Dementech Neurosciences Clinic we are offering end-to-end services for all the different levels of care that a patient requires.

We will use blood tests and imaging scans to precisely make the diagnosis and differentiate from other disorders.

Once the diagnosis has been established, our multidisciplinary team will do everything humanly possible to treat symptoms and prevent them from progressing further, hence improving the quality of each, the emotional health and the well being of each individual.

Initial Assessment and Diagnostic testing

The initial appointment for ET will consist of the following:

  1. Initial consultation with a specialist physician.
  2. Blood tests and imaging scans, outsourced to the highest quality and convenient centres in London.
  3. When all results are available, a 2nd consultation with the doctor, where clinical diagnosis & follow-up strategy are discussed and explained.
  4. If oral medications are not effective or well tolerated, Therapeutic injections will be considered.

Dystonias are neurological movement disorders affecting different part of the body, and cause involuntary muscle contractions. Cervical dystonia is the most common focal dystonia and it affects about 40,000 of people in UK per year. Cervical dystonia affects nerves supplying the neck and/or shoulder muscles resulting in twisting and repetitive movements. This causes the muscles to be held in abnormal positions that are typically quite painful and may be associated with some tremor. Another common type of dystonia is eye dystonia, known as ‘Blepharospasm’. Eye dystonia is uncontrollable, sustained, and often painful muscle contractions around the eye. Symptoms of eye dystonia may include excessive blinking and involuntary closure of the eyelids.

Small amounts of fillers are injected in the muscles and they block nerve signals that tell the muscles to contract. The effect is temporarily and lasts about 12 weeks. Our team of doctors have a broad experience in  injections and will effectively treat these disabling movement disorders.

Diagnosis – Prevention – Risk Assessment – Management

At Dementech Neurosciences Clinic we are offering end-to-end services for all the different levels of care that a patient requires.

We will use blood tests and imaging scans to precisely make the diagnosis and differentiate from other disorders.

Once the diagnosis has been established, our multidisciplinary team will do everything humanly possible to treat symptoms and prevent them from progressing further, hence improving the quality of each, the emotional health and the well being of each individual.

Initial Assessment and Diagnostic testing

The initial appointment for Dystonia will consist of the following:

  1. Initial consultation with a specialist physician.
  2. Blood tests and imaging scans, outsourced to the highest quality and convenient centres in London.
  3. When all results are available, a 2nd consultation with the doctor, where clinical diagnosis & follow-up strategy are discussed and explained and referral to Therapeutic Injections service will be made.
Multiple System Atrophy

Multiple System Atrophy (MSA) is a rare neurological disorder that develops in adulthood, usually in the 50s or 60s. MSA is caused by shrinking of nerve cells in several areas of the brain, which can result in problems with multiple bodily functions such as speech, movement, balance, blood pressure and bladder control. The diagnosis of MSA is based mainly on clinical features. There are two types of MSA: parkinsonian and cerebellar, depending on which types of symptoms predominate. Most patients do not receive the correct diagnosis during their lifetime because of the difficulty in differentiation from other disorders, particularly Parkinson’s disease. Currently, no therapy can reverse or slow down the progression of the disease. Management is symptomatic and targets Parkinsonism, bladder and blood pressure symptoms.

 

Progressive supranuclear palsy

Progressive supranuclear palsy (PSP) is an uncommon neurological disorder with typical onset in the middle 60s associated with the over-production of a protein called tau in certain areas of the brain. Tau forms into clumps – or neurofibrillary tangles – which are believed to damage nerve cells. PSP symptoms include loss of balance, falls (often backwards), stiffness and difficulties with vision, speech and swallowing. Eye problems cause difficulty in looking up or down, focusing, double or tunnel vision and dislike of bright lights. Some people can also experience behavioural and cognitive changes including depression and apathy. There is no current treatment that can reverse its progression or slow it down and management is symptomatic and targets Parkinsonism and mood symptoms.

 

Corticobasal Syndrome

Corticobasal Syndrome (CBS) is a very rare neurological disease, affecting people from the age of 40 onwards. Although there are similarities to PSP, with similar nerve cell damage and the build-up of a protein called tau in certain parts of the brain, the classical clinical picture is quite distinct. However people diagnosed with CBS may develop features of PSP and vice versa. PSP and CBS can overlap. CBS causes gradually worsening difficulties with movement, speech, memory and swallowing. Some patients will experience an involuntary stiffening, twisting or contraction of the affected limb called dystonia. There may be uncontrolled jumping of the limb when it is tapped gently or when the patient is startled, called myoclonus. People with CBS often complain that the affected limb feels like it is not a part of their body, a sensation called alien limb. There is no specific treatment for CBD. Instead individual symptoms are targeted with specific medications.

At Dementech Neurosciences, we offer a multidisciplinary approach to treat Parkinsonism, neuropsychiatric and cognitive symptoms of atypical Parkinsonism. We have in-house speech and language therapist, occupational therapist, dietitian, psychologist and psychiatrist to offer a multidisciplinary approach for the management of these complex neurodegenerative disorders. Caregivers may experience significant stresses and have a high level of burden; therefore we also offer caregiver support. At Dementech Neurosciences, we have the possibility to assess in vivo tau protein aggregates using a special type of brain scan called positron emission tomography (PET), which can be used to measure chemical changes within the brain and consequently study the functions of the brain. This novel imaging tool will enable early diagnosis of these neurodegenerative diseases before extensive cell loss and symptoms become evident. Additionally, Tau PET can also serve as an indicator of treatment efficacy for interventions aimed at preventing tau aggregate formation. Moreover, we offer the opportunity to participate in clinical trials testing novel pharmacological intervention, before they become available to the public, aiming to delay the progression of the disease.

Diagnosis – Prevention – Risk Assessment – Management

At Dementech Neurosciences Clinic we are offering end-to-end services for all the different levels of care that a patient requires.

Risk assessments, prevention strategies and tools are used, as it is far more efficient to prevent a disease from developing rather than try to treat it once it has progressed.

However, in cases where a diagnosis of a disease has been established, our multidisciplinary team will do everything humanly possible to treat symptoms and prevent them from progressing further, hence improving the quality of each, the emotional health and the well being of each individual.

Initial Assessment and Diagnostic testing

The initial appointment for Atypical Parkinsonism will consist of the following:

  1. Initial consultation with a specialist physician.
  2. Appointment with a neuropsychologist in the Neuropsychiatric Laboratory for computerized, detailed assessments of cognitive deficits and other neuropsychiatric issues associated with movement disorders.
  3. Appointment for the PKG Service, which is a wrist worn device, that looks like a watch and automatically records movement data to assist in their diagnosis and treatment of the symptoms of movement disorders.
  4. Blood tests and imaging scans, outsourced to the highest quality and convenient centres in London.
  5. When all results are available, a 2nd consultation with the doctor, where clinical diagnosis & follow-up strategy are discussed and explained.

Huntington’s disease (HD) is an inherited disease that damages some of the nerve cells in the brain causing gradual loss of function of areas of the brain. Especially affected are those areas of the brain called the basal ganglia and cerebral cortex, which are involved in the control of movement, cognition, and behaviour. HD is caused by a faulty gene and the diagnosis is confirmed by genetic test. As HD is inherited dominantly, a child of a parent who has the disease has a 50% chance of inheriting the defective gene. People can get HD symptoms between 35 and 55 years old, though slight behavioural changes and deficits in motor function can occur several years before. There is a wide range of variation in the first presentation of symptoms for people carrying the HD gene, and much is still unknown about the way the disease progresses from initial signs to development of overt motor symptoms. As the disease progresses, involuntary movement, emotional changes and memory disturbances will become more severe. Although some symptoms can be managed with medications, there is no current treatment that can reverse its progression or slow it down.

At Dementech Neurosciences, we offer a multidisciplinary approach to treat all the variety of symptoms of HD. We have in-house speech and language therapist, occupational therapist, dietitian, psychologist and psychiatrist to manage effectively HD symptoms and complications. We use state-of-the-art technology such as the PKG to monitor and treat HD symptoms. Neuropsychiatric and cognitive impairment may occur even at the early stage of the disease before the development of motor symptoms. At Dementech Neurosciences we use cutting-edge technology CANTAB to assess the severity of cognitive deficits in people with HD. This enables us to provide an early diagnosis of cognitive impairment and effectively manage it. We also provide genetic screening and counselling for the family carrying the HD gene expansion mutation. Moreover, we offer the opportunity to participate in clinical trials testing novel pharmacological intervention, before they become available to the public, aiming to delay the progression of the disease.

Diagnosis – Prevention – Risk Assessment – Management

At Dementech Neurosciences Clinic we are offering end-to-end services for all the different levels of care that a patient requires.

Risk assessments, prevention strategies and tools are used, as it is far more efficient to prevent a disease from developing rather than try to treat it once it has progressed.

However, in cases where a diagnosis of a disease has been established, our multidisciplinary team will do everything humanly possible to treat symptoms and prevent them from progressing further, hence improving the quality of each, the emotional health and the well being of each individual.

Initial Assessment and Diagnostic testing

The initial appointment for Huntington’s disease will consist of the following:

  1. Initial consultation with a specialist physician.
  2. Appointment with a neuropsychologist in the Neuropsychiatric Laboratory for computerized, detailed assessments of cognitive deficits and other neuropsychiatric issues associated with movement disorders.
  3. Appointment for the PKG Service, which is a wrist worn device, that looks like a watch and automatically records movement data to assist in their diagnosis and treatment of the symptoms of movement disorders.
  4. Blood tests and imaging scans, outsourced to the highest quality and convenient centres in London.
  5. When all results are available, a 2nd consultation with the doctor, where clinical diagnosis & follow-up strategy are discussed and explained.

Restless Legs Syndrome (RLS) is a neurological disorder, affecting up to 10% of people in the UK, characterised by an irresistible urge to move to stop uncomfortable or odd sensations. RLS affects the legs but can affect the arms, head, and other parts of the body. Moving the affected body part can temporarily suspend the sensations associated with RLS, thereby providing temporary relief. RLS can cause considerable discomfort during waking hours, particularly when the patient is in a relaxed state. However RLS is usually most acutely experienced in the evening or at night when people are trying to sleep. RLS can lead to long sleepless nights and daytime fatigue and invariably impacts on the quality of life of the patient, including their employment, and those close to them. There are two recognised forms of RLS:

Primary or idiopathic RLS has no known cause and usually begins before 40–45 years of age. It is often genetically linked and it is likely that another family member may also share the condition. Primary RLS can come and go, sometimes for months on end, and often gets worse with age. Secondary RLS often has a sudden onset and is usually associated with another medical condition (e.g. iron deficiency, anaemia) or the use of certain drugs. Several medications are ale to ameliorate RLS symptoms, however, many people living with RLS are misdiagnosed or not diagnosed at all.

At Dementech Neuroscience, our team of clinicians can provide rapid and accurate diagnosis of this disease and offer the right treatment and management. Moreover, we offer the opportunity to participate in clinical trials  testing novel pharmacological intervention, before they become available to the public, aiming to treat and delay the progression of the disease.

Diagnosis – Prevention – Risk Assessment – Management

At Dementech Neurosciences Clinic we are offering end-to-end services for all the different levels of care that a patient requires.

We will use blood tests and imaging scans to precisely make the diagnosis and differentiate from other disorders.

Once the diagnosis has been established, our multidisciplinary team will do everything humanly possible to treat symptoms and prevent them from progressing further, hence improving the quality of each, the emotional health and the well being of each individual.

Initial Assessment and Diagnostic testing

The initial appointment for Huntington’s disease will consist of the following:

  1. Initial consultation with a specialist physician.
  2. Blood tests and imaging scans, outsourced to the highest quality and convenient centres in London.
  3. When all results are available, a 2nd consultation with the doctor, where clinical diagnosis & follow-up strategy are discussed and explained.
Subservices